39 - Drugs causing myopathy

1. lipid lowering agents :

 

                                1a. fibric acid derivatives

                                1b. HMG CoA reductase inhibitors ( statins )

                                1c. niacin ( nicotinic acid derivatives )

 

2. glucocorticoids

 

3. zidovudine

 

4. Non depolarizing neuromuscular blocking agents

 

5. drugs of abuse :

 

                           5a. alcohol

                           5b. amphetamines

                           5c. cocaine

                           5d. heroin

                           5e. phencyclidine

                           5f. meperidine

 

6. autoimmune toxic myopathy : D – pencillamine

 

7. amphophilic cationic drugs :

 

                                  7a. amiodarone

                                  7b. chloroquine

                                  7c. hydroxychloroquine

 

8. antimicrotubular drugs : colchicine

 

9. miscellaneous drugs :

 

                            9a. cyclosporine

                            9b. cimetidine

                            9c. gold

                            9d. danazol

                            9e. amphotericin – B  

38 - glucose 6 phosphate dehydrogenase deficiency - hemolysis causing drugs

1. all of the following drugs cause definite hemolysis in a glucose-6-phosphate dehydrogenase deficient patient except ?

a. primaquine
b. nitrofurantoin
c. naphthalene
d. ciprofloxacin

answer: d . ciprofloxacin . 

u have to memorise the following drugs to answer questions related to this topic.

Drugs which carry a definite risk of hemolysis in a patient with glucose-6-phosphate dehydrogenase deficiency :

1. antimalarials : primaquine, dapsone/chlorproguanil
2. sulphonamides/sulphones : sulphamethoxazole and others, dapsone
3. antibacterial/antibiotics : cotrimoxazole, nalidixic acid, nitrofurantoin, niridazole
4. antipyretic/analgesics : acetanilide, phenazopyridine (pyridium)
5. other drugs : naphthalene, methylene blue

Drugs which carry a possible risk of hemolysis in a patient with glucose-6-phosphate dehydrogenase deficiency :

1. antimalarials : chloroquine
2. sulphonamides : sulfasalazine, sulfadimidine
3. antibacterials/antibiotics : ciprofloxacin, norfloxacin
4. antipyretic/analgesics : acetylsalicylic acid high dose ( greater than 3 g/d )
5. other drugs : vitamin K analogues, ascorbic acid greater than 1 gram and rasburicase

Drugs which carry a doubtful risk of hemolysis in a patient with glucose-6-phosphate dehydrogenase deficiency :

1. antimalarials : quinine
2. sulphonamides/sulphones : sulfisoxazole, sulfadiazine
3. antibacterial/antibiotics : chloramphenicol, p-aminosalicylic acid
4. antipyretic/analgesics : acetyl salicylic acid less than 3 g/d, acetaminophen, phenacetin
5. other drugs : doxorubicin, probenecid .